Abstrakt
The aim of this study was to obtain comprehensive information about standard practice in management of dementia among specialists responsible for the care of patients with cognitive deterioration in the Czech Republic. Methods: The data were collected by the means of structured questionnaires completed by neurologists, psychiatrists and geriatricians during seminars focused on cognitive topics.
Results: 152 specialists were participating in the study. The respondents saw the mean of 27 patients with cognitive deficit monthly, 33% of whom suffer from Alzheimer disease.
Neurologists diagnosed equal proportions of patients with mild cognitive impairment, and with mild to moderate stages of dementia; psychiatrists and geriatricians mostly diagnose patients at the moderate stage of the disease. Nearly all of the neurologists and half of the psychiatrists examined their patients by MRI or CT prior to starting therapy.
SPECT was mainly used by neurologists (42%). The majority of patients took cholinesterase inhibitor (ChEI) for 2-3 years.
Half of the specialists occasionally used dual therapy with ChEI and memantine. Nootropics were administered more frequently by psychiatrists.
All the respondents prescribed an Selective Serotonin Reuptake Inhibitors (SSRI) for the therapy of coinciding depression. Conclusion: Dementia was managed by the majority of specialists according to the EFNS guidelines.
The early stages of the disease were mostly handled by neurologists, who also tend to employ more sophisticated diagnostic tools in differential diagnosis of dementia.